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Midterm PollEV Flashcards

1
Q

You are performing lb dressing with a patient. Reaching to the floor, which muscle contraction and muscle groups are primarily working?

concentric of flexors

eccentric of flexors

Eccentric extensor

Concetric extensors

A

Eccentric extensor

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2
Q

During your treatment session, you are working with your patient to be able to weight shift to the right in prep for scooting. What is happening to the trunk on the weightbearing side?

shortening

elongation

shortening then elongation

None of the above

A

elongating

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3
Q

You are working with a stroke patient on trunk control in sitting and you place a shirt on their right side and have them reach with the left arm. What are the prime movers for this movement?

Left external obliques & Right internal obliques

Isometric contraction of flexors and extensors

Right External obliques & left internal obliques

Lateral flexors

A

Left external obliques & Right internal obliques

(rotating to right)

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4
Q

You are having a patient initiate lateral trunk flexion with their upper trunk to the right side. _________will occur on the right side of the trunk , while ______ on the left side.

shortening, elongation

elongation, shortening

shortening, shortening

Nothing, elongation

A

shortening (right), elongation (left)

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5
Q

You are working with an MS patient who has sitting balance issue. You work on UE dressing on the mat followed by sitting on a half ball while playing cards at the table. These are considered ______and ______ pertubations, respectively.

Internal, External

Internal, Internal

External, Internal

External, External

A
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6
Q

UE dressing is what type of pertubation?

A

Internal

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7
Q

What are the two main areas one needs to assess before PROM greater than 70 degrees in shoulder flexion?

Shoulder External and Internal Rotation
Shoulder internal rotation and scapular upward rotation
Shoulder external rotation and scapular retraction
Shoulder external rotation and scapular upward rotation

A

Shoulder external rotation and scapular upward rotation

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8
Q

You are seeing a patient who has MMT of 3-/5 in the shoulder flexors and AROM 0-60 degrees, what would be the best treatment for this patient?

Reaching into upper cabinets
Pendulluum exercises
Washing the rear window of a car
Weight bearing in standing at the kitchen counter

A

Washing the rear window of a car

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9
Q

You have a patient with a 2 finger breadth inferior subluxation. The following would be appropriate interventions EXCEPT

Use of a sling all the time, unless in therapy
Kinesiotape or athletic tape
Givmohr sling during standing activities
Sling only during transfers and specific activities

A

Use of a sling all the time, unless in therapy

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10
Q

The following are component of Constraint Induced Movement Therapy EXCEPT:

Task practice
Mitt over the unaffected hand
Transfer Package: Behavioral contract for adherence
Rote exercise

A

Rote exercise

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11
Q

Proper management of the neurologic UE is extremely important to decrease shoulder hand syndrome (SHS). The following interventions would be appropriate to prevent SHS EXCEPT

Proper positioning of the arm in the bed and wheelchair to prevent pain
No shoulder flexion PROM past 70 degrees without scapular assessment
Education of the patient, caregiver, and team about care of the neurologic UE
Overhead pulley exercises in sitting

A

Overhead pulley exercises in sitting

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12
Q

Your patient has left sided weakness from a CVA. The patient is sitting at a table and you have them reach for a cup across the table and you notice large synergistic movements. Which of the following treatment would be BEST for this patient?

Add a 1 lb weight to the patient arm
Have patient do shoulder flexion AROM exercises
Do the same reach with use yellow theraband for minimal resistance
Have patient reach for a cup on the floor

A

Do the same reach with use yellow theraband for minimal resistance

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13
Q

Which of the following standardized assessments is subjective and examines how much and how well the stroke survivor uses their affected arm?

Action Research Arm Test
Fugl-Meyer Assessment
Motor Activity Log
Wolf Motor Function test

A

Motor Activity Log

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14
Q

You decide to use e-stimulation for a patient who has an inferior subluxation. E-stimulation of which muscle would NOT help the inferior subluxation?

Supraspinatus
Middle deltoid
Posterior Deltoid
Rhomboids

A

Rhomboids

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15
Q

You are observing a patient during grooming and you notice that they are having trouble with manipulating the toothbrush and maneuvering in their mouth from the right to left side. Which perceptual deficit is this most likely?

ideational apraxia
motor apraxia
neglect
spatial relations

A

motor apraxia

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16
Q

You are treating a patient with a right CVA and left sided weakness. They are having difficulty putting on their shirt (e.g. placing arm in the wrong hole), but can verbalize what they are trying to do. Which perceptual deficit is this most likely?

Ideational apraxia
somatoagnosia
spatial relations
perseveration

A

spatial relations

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17
Q

You go up to your patients room after lunch and you notice that he ate the food on the right side of the plate, not the left. Which functional assessment would be the BEST to confirm your assumption of the perceptual deficit?

Line cancellation
Kessler Foundation- Neglect assessment process
Multiple Errands Test
Kettle Test

A

Kessler Foundation- Neglect assessment process

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18
Q

The A-one is a standardized functional test that enables OT’s to clinically reason which perceptual deficit is causing difficulty for the patient. The following are preparatory steps/procedures to perform the A-One EXCEPT:

Place all needed ADL objects/tools in arms length of patient
Place necessary items to complete a task on opposite sides (eg. one sock on left side and one sock on right side of patient)
Allow for safe errors
Provide physical assist first when assistance in needed

A

Provide physical assist first when assistance in needed

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19
Q

You walk into your patient’s room and you see him using his fork to eat his soup. Which perceptual deficit is it most likely?

ideational apraxia
perseveration
somatoagnosia
Need more information/observations

A

Need more information/observations

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20
Q

You are treating a patient with Anosognosia. What would be the best first treatment approach?

Attention training
Functional mobility
Awareness training
Memory training

A

Awareness training

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21
Q

The following statements are True when comparing neglect with a visual field loss (VFL) EXCEPT:

People with neglect have a lack of awareness. People with VFL are aware of their deficit.
VFL is a sensory deficit, while neglect is a attention deficit.
Compensatory strategies are easily taught for people with neglect and not VFL.
Cortical representation of the whole world is intact with VFL and not with neglect.

A

Compensatory strategies are easily taught for people with neglect and not VFL.

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22
Q

You are observing a patient who is having difficulty finding objects in a crowded drawer. Which perceptual deficit is this most likely?

Topographical Disorientation
Spatial relations
Foreground/background
Depth perception

A

Foreground/background

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23
Q

The following would be a appropriate treatment strategies with a person with motor apraxia EXCEPT?

Closed chain strategies
decreasing the degrees of freedom
examine critical features of the object
strategy training

A

examine critical features of the object

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24
Q

The following are treatment strategies for which perceptual deficit: critical features of the items, pictures of the task, show items needed for task.

motor apraxia
neglect
ideational apraxia
spatial relations

A

ideational apraxia

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25
The following treatments would be remedial strategies for left neglect EXCEPT? PROM of left UE Vibration to LUE Anchoring of LUE Placing objects on the right side
Placing objects on the right side
26
While dressing, you educate the patient on areas to focus on such as the collar, buttons, tags in order to assist with dressing (I). Which perceptual deficit does the patient most likely have? Motor apraxia Spatial relations Neglect Perseveration
Spatial relations
27
During your home treatment session, you have the patients sort items in the kitchen drawers, organize the cabinets, and de-clutter. This patient most likely has which perceptual deficit? Ideational Apraxia Neglect Figure-ground prosopagnosia
Figure-ground
28
The following treatments would be appropriate to teach a person with Prosopagnosia in order to identify who the person is EXCEPT: Use their voice Use critical feature on their body (scar,tattoo) Focus on the characteristics of their face Identify the specific small of the person
Focus on the characteristics of their face
29
Examples: Loosing track of what was just said or done
working memory
30
Example: does not remember what was done in a treatment session that morning or the day before
episodic long term
31
Examples: Does step 1 and step 3 but forgets to do step 2
working memory
32
Example: Forgot how to operate the coffee machine
procedural
33
Example: forgetting to take medication
prospective memory
34
Example: forgets what the toothbrush is so keeps asking
Semantic (facts/vocab)
35
What is one of the first things to look at for cognitiion?
awareness
36
Lack of awareness example
Post-stroke, patient has bad balance, no arm movement, patient may think they can go home
37
Pyramidal Model of awareness (3 stages)
(1) intellectual awareness (2) emergent awareness (3) anticipatory awareness
38
Poor initiation, organization and sequencing (can stand alone), incorrect tool use (toothbrush to brush hair, fingers to brush teeth)
ideational apraxia
39
Ex: brush hair with toothbrush, brush teeth with comb, use fingers as tools)
ideational apraxia
40
Clumsy movement, difficulty re-adjusting arm/hand movements when crossing midline, awkward grasp, difficulty manipulating objects, difficulty with gesture
motor apraxia (ideomotor)
41
Preservation (prefrontal or premotor cortex)
Difficulty shifting from one pattern of response to another Premotor Prefrontal Speech
42
Body scheme disorders
unilateral body neglect somatoagnosia
43
What are you likely to see with a left CVA?
- language issues - bilateral motor apraxia - ideational apraxia - preservation
44
What are you likely to see with a right CVA?
- spatial relations - spatial and body neglect - topical disorientation - left motor apraxia - decreased insight and judgment - preservation
45
What makes an assessment subjective?
Reliance on personal interpretation, judgment, and qualitative aspects
46
What is the difference between the ETAM and the E-ADL?
ETAM is more IADL focused while the E-ADL is ADL focused
47
Executive function performance test
Analysis of occupational performance Cognitive processes that support or limit performance Focus on 5 executive functions --- initiation, organization, sequencing, judgment, safety, completion
48
Performance Assessment of Self-Care Skills (PASS)
Objective Measures ADL & IADL (with cognitive emphasis) Each task is divided into subcomponents and scored according to type and amount of cueing
49
Kettle test
Objective - analysis of occupational performance - cognitive processes that support or limit performance like screening, executive function, working memory, awareness/safety
50
Task analysis with cuing (general form with cueing)
task or routine cueing
51
Error analysis
Looks at what errors made, error patterns, and strategies
52
What assessments are ideal for error analysis?
Multiple Errands Test (met) Cognitive processes support or limit performance Weekly Calendar Planning Acrtivity
53
Multiple Errands Test
Subjective! - analysis of occupational performance
54
Other assessments for error analysis:
- Behavioral Inattention test (BIT) - Fluff test - Contextual Memory Test (CMT1) - Cognitive Assessment of Minnesota (CAM) - all of these are objective
55
Improving awareness? Metacognitive training:
Have patient perform tasks of interest and provide feedback about their performance Encourage self-questioning during task Provide methods of comparing functioning pre- and post- injury to improve awareness
56
Remediation
Aka restorative or transfer of training approach (bottom up) Focus on decreasing impairment Requires ability to learn and generalize the intervention strategies to a real world situation
57
adaption/compensation/functional
Aka functional approach (top down) Focus on decreasing activity limitations & participation restrictions Client centered and typically utilizes practice of functional activities Emphasizes modification (task or environment) Uses a compensatory strategy
58
Recommended approach: cognitive treatment
Combination! - reject dichotomy between approaches - use relevant occupations as treatment modalities to challenge components
59
Example of activity processing: tooth brush task (used to challenge underlying impairments) - Spatial relations/spatial positioning
Positioning of toothpaste/toothbrush while applying toothpaste, placement of toothbrush in mouth, positioning of bristles, placement of toothbrush underwater
60
Example of activity processing: tooth brush task (used to challenge underlying impairments) - spatial neglect
Visual search for toothbrush, tooth brush and faucet handle on affected side
61
Example of activity processing: tooth brush task (used to challenge underlying impairments) - body neglect
Brushing on affected side
62
Example of activity processing: tooth brush task (used to challenge underlying impairments) - motor apraxia
Manipulation of toothbrush, cap of toothpaste, squeezing toothpaste
63
Example of activity processing: tooth brush task (used to challenge underlying impairments) - ideational apraxia
Appropriate use of toothbrush
64
Example of activity processing: tooth brush task (used to challenge underlying impairments) - organization & sequencing
Sequencing of tasks (removal of cap, application of toothbrush, turning on water, put toothbrush in mouth)
65
Example of activity processing: tooth brush task (used to challenge underlying impairments) - attention
Attention to tasks (for increased difficulty: distractions, flush toilet, etc.), refocus on task after distraction
66
Example of activity processing: tooth brush task (used to challenge underlying impairments) - figure ground
Distinguishing white toothpaste and toothbrush from sink
67
Example of activity processing: tooth brush task (used to challenge underlying impairments) - initiation
Initiation on command
68
Example of activity processing: tooth brush task (used to challenge underlying impairments) - visual agnosia
Use of tough to identify objects
69
Example of activity processing: tooth brush task (used to challenge underlying impairments) - Problem solving
Search for alternative if something is missing (do they ask where is something, do they search for missing items, do they use their finger as a tool to brush teeth)
70
An example of a behavioral modification: backward chaining
Put on shirt and have them do last step, then next time have them finish last 2 steps
71
Treatment for neglect
- Visual scanning training - lighthouse strategy - limb activation - anchoring - place objects to left, approach patient on left - prisms - cueing - patient and family education
72
Compensation for neglect
Place items on right side Organize closet, drawers to have items on the right side Call bell always on the right Colored markers on furniture that may be an obstacle or de-clutter Rotate chair to left 45° during table top activities (ex: games, feeding) or move items to right
73
Treatment for spatial relations syndrome
- spatial relations dysfunction: place items in certain places and identification dressing via collars - figure ground: slow down during task to identify relevant objects, sort objects, declutter - topographical organization: colored dots, map training, directional instructions
74
Treatments for apraxia
- usage of meaningful tasks & objects - repetition & practice with own objects in appropriate environments and time of day - strategy training (focus on errors made during task) - practice functional activities with vanishing cues - errorless learning
75
Treatment for ideational apraxia
- hand over hand assist - provide only 1 tool at a time, then add more difficulty - show picture of task and object needed for task - feel object and assess specific features of object - hand only 1 object to person
76
treatment for motor apraxia
- hand over hand assist - keep tasks closed chain - decreased DOF - demonstrate performance and break down parts
77
Treatment for initiation
- goal oriented tasks - physical target/ visual - "we will start in 1,2,3" - demonstrate task - show pictures
78
treatment for preservation
- physically stop task or movement - assist in initiating another movement or task
79
General treatment for agnosia
generally focus on patient to use intact sensory modalitiess
80
Treatment for visual object agnosia
- use tactile info - use spatial & location info to recognized objects - use relevant & critical features of objects - practice at identifying real objects
81
treatment for tactile agnosia
use vision
82
treatment for prosopagnosia
Use gait, voices, clothing to recognize people Highlight distinguishing features (mustache, scar, tattoo) Use localization cues (ex: dave always sits in front of me in class)
83
treatments for memory
Memory drills has been unsuccessful in terms of generalization to meaningful activities - errorless learning - compensatory strategies -creation of associations - keep in mind learning new skills

Adults III (6 decks)

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